Surgical Management and Clinical Outcomes of Mediastinal Mass Resections: A Single-center Retrospective Analysis

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Aim: The surgical management of mediastinal masses is complex due to anatomical constraints and diverse pathologies. This study aims to provide a descriptive analysis of surgical outcomes, risk factors for complications, and survival trends in patients undergoing mediastinal mass resection. Methods: We retrospectively reviewed the records of 36 patients who underwent surgical resection of mediastinal masses between 2019 and 2026. Postoperative complications were graded using the Clavien-Dindo classification. Demographic data, tumor characteristics, and pathological subtypes were analyzed. Long-term survival was estimated using the Kaplan-Meier method, and risk factors for major complications (Grade ≥III) were evaluated. Results: The study cohort consisted of 26 females and 10 males with a mean age of 53.69±14.19 years. Major complications occurred in 13.9% (n=5) of patients. A significant association was found between major complications and smaller tumor diameters (31.14±14.0 mm vs. 53.55±23.8 mm, p=0.022) and a history of malignancy (p=0.028). The 30-day mortality rate was 2.8% (n=1). While major complications did not adversely affect 5-year overall survival (p=0.486), a strong trend toward prognostic divergence was observed across different pathological subtypes (log-rank p=0.056), with metastatic lesions showing poorer outcomes. Conclusion: Mediastinal mass resection remains a clinical necessity and is inherently challenging. Given the vast pathological variety and technical demands of the mediastinum, continuous documentation of institutional experiences is essential for refining preoperative planning and complication management strategies. Successful outcomes depend on the integration of surgical precision with robust perioperative care.